go back

Nebraska rates for HCPCS Q4117

HYALOMATRIX, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $29 · 10th–90th $17–$2090%10%10th90th$29Professionalmedian $23 · 10th–90th $22–$340%20%10th90th$23$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $28.84 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $22.91 / $28.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $18.20 / $19.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $18.20 / $19.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $26.30 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $28.84 / $45.71
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $31.62
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $26.30 / $28.84
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.95 / $26.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $48.98 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $120.23 / $125.89